To discuss the management of a rare case of cerebral edema before initiation of therapy in an adolescent with new-onset type 2 diabetes. The University of Arkansas for Medical Sciences Institutional Review Board approved the review of medical records. A previously healthy obese adolescent female suffered diabetic ketoacidosis (DKA)-related cerebral edema before initiation of therapy. Prompt management was associated with complete recovery. DKA-related cerebral edema before treatment can occur in patients with new-onset type 2 diabetes. Use of mannitol and hypertonic saline solution should be considered in the management of DKA-related cerebral edema.
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